Individual provider Active NPI

Andrew James Odland, D.O.

  • Family Medicine Physician
  • Pendleton, OR
National Provider Identifier
1063117745
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO231313 Issued in OR
Practice address
2450 SW Perkins Ave
Pendleton, OR 97801-4302
Phone
(541) 276-1700
Fax
(541) 276-6327
NPI assigned
Apr 3, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 8612 OK
Family Medicine Physician 207Q00000X DO231313 OR Primary

Addresses

Primary practice location

2450 SW Perkins Ave
Pendleton, OR 97801-4302

Mailing address

PO Box 1517
Pendleton, OR 97801-4302
Phone (877) 708-1119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241202001375 OK Practitioner - Family Practice 2365977220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Precision Pain Management LLCGroup PAC ID 8628390515, 8 clinicians

Practice addresses (Care Compare)

4110 S 100TH E Ave
Suite 201
Tulsa, OK 74146-3629
Phone (918) 857-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Provectus Diagnostics LLC CurrentSince Nov 17, 2024 Accepting new patients
Precision Pain Management LLC Current Accepting new patients

Locations

4110 S 100th East Ave
Ste 201
Tulsa, OK 74146
Phone (918) 857-7246

Interoperability endpoints

  • Direct secure messaging: aodland1004093@ahs.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1063117745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978014302",
            "telephone_number": "877-708-1119",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 SW PERKINS AVE",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978014302",
            "telephone_number": "541-276-1700",
            "fax_number": "541-276-6327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODLAND",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "8612",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO231313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, OR

Sources for this page

Verify at the official NPI Registry.